Tips for talking to your family about long-term services and supports

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Talking about long-term services and supports before the need arises makes sense. Yet parents, children, spouses and partners often put it off. Even worse, we remain silent and hope things will work themselves out.

Sound familiar?

Talking about aging, finances and health can be uncomfortable and awkward. They are extremely personal and complex topics. But if you put a plan in place before a crisis occurs, your choices will be clear and likely fulfilled. That plan begins by having honest talks with those closest to you. Trained options counselors can help with those talks. These discussions can avoid others making important decisions when emotions are high, the choices are confusing and there’s little time to carefully weigh all the factors.

Determine what’s important to you

This is one of those rare times when it really is all about you. So first take the time to carefully consider the following questions.* If possible, have your spouse or partner do the same. When you’re ready, compare your answers. You may be surprised by how similar or different your answers are. That’s OK. Finding out where you agree or disagree will help guide future decisions and planning. Depending on your answers, you may want to consult with an elder law attorney.

How will you pay for your long-term services and supports expenses?

• Do you have enough savings and resources to pay for your long-term services and supports? Are you comfortable with the impact this may have on leaving an inheritance for your family or providing for them in other ways?
• Would you sell your home to pay for care?
• If needed, could your children help pay for your long-term services and supports expenses? Would you want them to do that? Have you talked with them about this?
• Are you counting on Medicaid? Remember that you may need to spend down your savings and other finances to be eligible for it.

How will you maintain control of your finances?

• Are you comfortable letting someone else take control of your finances? Who would you ask to do this?
• How important is having the peace of mind that you have planned for your financial needs?
• Would you consider designating a financial power of attorney to manage your finances the way you want?

Who will take care of you?

• Is staying at home for as long as possible important to you? If so, would you be comfortable with in-home help?
• Do you expect friends, children or other relatives to help take care of you in your home?
• Would you move in with one of your children or another relative? Have you discussed this with them?
• Would you consider living in an assisted living facility, continuing care retirement community or nursing home?

Start talking and planning

Now you are ready to talk with your children, family or others close to you. You will choose who to talk to and what to discuss. The important thing is to start talking. If that’s hard, an options counselor can help you and your family. Once you start, you may find that everyone is relieved to talk about it.

How to start the conversation

• Be clear about why discussing the issue is important to you.
• Be prepared. Make sure you’ve thought through key issues.
• Remember that listening is also part of communication. Recognize that family members’ feelings and opinions may differ from yours.
• Look for natural chances to talk. Ask, “What would you have done if you were in that situation?”
• Begin by noting some of your concerns about the long-term services and supports decisions.
• Don’t try to tackle too many issues at once. It may be easier to talk a few times.

Your discussions can be the foundation for a long-term services and supports plan.

Perhaps your family is not comfortable talking about your long-term services and supports needs. Acknowledge their feelings, share your concerns and perhaps try again later. A trained options counselor can also help.

* Questions based on content developed by Marlene S. Stum, Ph.D., Financial Security in Later Life National Initiative Development Team member from Family Social Science, University of Minnesota. Copyright 2002, University of Minnesota Regents. Materials may be copied for educational purposes only.